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01.06.2014 | Review | Ausgabe 3/2014

International Journal of Public Health 3/2014

Explanatory models concerning the effects of small-area characteristics on individual health

Zeitschrift:
International Journal of Public Health > Ausgabe 3/2014
Autoren:
Sven Voigtländer, Verena Vogt, Andreas Mielck, Oliver Razum
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00038-014-0556-8) contains supplementary material, which is available to authorized users.
S. Voigtländer and V. Vogt contributed equally to this work.
This article is part of the special issue “Explaining Health Inequalities: The Role of Space and Time”.

Abstract

Objectives

Material and social living conditions at the small-area level are assumed to have an effect on individual health. We review existing explanatory models concerning the effects of small-area characteristics on health and describe the gaps future research should try to fill.

Methods

Systematic literature search for, and analysis of, studies that propose an explanatory model of the relationship between small-area characteristics and health.

Results

Fourteen studies met our inclusion criteria. Using various theoretical approaches, almost all of the models are based on a three-tier structure linking social inequalities (posited at the macro-level), small-area characteristics (posited at the meso-level) and individual health (micro-level). No study explicitly defines the geographical borders of the small-area context. The health impact of the small-area characteristics is explained by specific pathways involving mediating factors (psychological, behavioural, biological). These pathways tend to be seen as uni-directional; often, causality is implied. They may be modified by individual factors.

Conclusions

A number of issues need more attention in research on explanatory models concerning small-area effects on health. Among them are the (geographical) definition of the small-area context; the systematic description of pathways comprising small-area contextual as well as compositional factors; questions of direction of association and causality; and the integration of a time dimension.

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Zusatzmaterial
Supplementary material 1 (DOC 64 kb)
38_2014_556_MOESM1_ESM.doc
Literatur
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